Gastric emphysema
Disclosures
- updated 10 May 2022:
Nothing to disclose
Updates to Article Attributes
Body
was changed:
Gastric emphysema, referring to the presence of gas in the wall of the stomach, is a relatively rare imaging finding 1. The stomach is the least common location for intramural gas in the gastrointestinal tract.
Pathology
Aetiology
There is a wide range of causes, ranging from life-threatening emphysematous gastritis to many self-limiting causes. Gastric emphysema is more common than emphysematous gastritis, but the two conditions may appear similar. Clinical presentation helps distinguish the two.
Gastric emphysema can be broadly divided into two categories based on aetiology 2:
- gastric causes
- emphysematous gastritis (i.e. infectious)
- ischaemia
- caustic ingestion
- increased intraluminal pressure (e.g. during endoscopy, over-eating 3, severe vomiting or in the setting of bowel obstruction)
- perforated gastric ulcer
- traumatic causes (e.g. endoscopic biopsy, endoscopic argon plasma coagulation, tube placement, blunt trauma)
- idiopathic
- extragastric causes
- small or large bowel ischaemia
- gangrenous cholecystitis
- dissection of pulmonary gas (such as from rupture of a pulmonary bulla)
-<li>perforated <a title="Gastric ulcer" href="/articles/peptic-ulcer-disease">gastric ulcer</a>- +<li>perforated <a href="/articles/peptic-ulcer-disease">gastric ulcer</a>
-<li>traumatic causes (e.g. endoscopic biopsy, endoscopic argon plasma coagulation, <a title="Nasogastric tube positioning" href="/articles/nasogastric-tube-positioning">tube placement</a>, blunt trauma) </li>- +<li>traumatic causes (e.g. endoscopic biopsy, endoscopic argon plasma coagulation, <a href="/articles/nasogastric-tube-positioning">tube placement</a>, blunt trauma) </li>
-<a title="Small bowel ischaemia" href="/articles/small-bowel-ischaemia">small</a> or large <a title="Bowel ischaemia" href="/articles/mesenteric-ischaemia">bowel ischaemia</a>- +<a href="/articles/small-bowel-ischaemia">small</a> or large <a href="/articles/mesenteric-ischaemia">bowel ischaemia</a>
-<li>dissection of pulmonary gas (such as from rupture of a <a title="Pulmonary bullae" href="/articles/pulmonary-bullae">pulmonary bulla</a>)</li>- +<li>dissection of pulmonary gas (such as from rupture of a <a href="/articles/pulmonary-bullae">pulmonary bulla</a>)</li>
References changed:
- 4. Misro A & Sheth H. Diagnostic Dilemma of Gastric Intramural Air. Ann R Coll Surg Engl. 2014;96(7):e11-3. <a href="https://doi.org/10.1308/003588414X13946184901128">doi:10.1308/003588414X13946184901128</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25245715">Pubmed</a>